The question may be asked: What other places can one find pharmacists? As we have discussed in previous columns there are many places where pharmacists make positive impacts on health care outcomes other than the traditional community pharmacy.
Opioid Treatment Programs, also known as methadone clinics, specialize in treating people with opioid addictions, particularly heroin. The consultant pharmacist is responsible for overseeing the inventory of methadone (a controlled substance) and ensuring the inventory is accurate and monitored for any diversion. The pharmacist visits a minimum of twice a month, and during the visits, the methadone inventory is counted and compared to the inventory count at the clinic. If there is a discrepancy the error is resolved before the pharmacist leaves the facility. Methadone is given to patients in prescribed doses and is helpful in having people escape the addiction of heroin or other opioids. The pharmacist monitors the doses that are prescribed for a random group of patients to make sure the dosing is being done correctly.
Another facility that uses a consultant pharmacist is a Crisis Stabilization Unit (CSU). When people go through an extreme emotional crisis, they are sometimes brought to a CSU. In this kind of facility, there is a secure medication room where a variety of commonly used medications are kept to treat the emotional and medical needs of the patient. The consultant pharmacist is responsible for the medication system at the facility and visits monthly to monitor the medication stock for any outdated products. Because a CSU is where emotionally disturbed patients are treated, it stocks some controlled drugs that are used to bring calming and/or sedation. The pharmacist makes sure all the counts are accurate and every dose taken out of stock is administered to the patient by monitoring the recording of the dose in the medication administration record (MAR). During each visit, the pharmacist conducts a random audit of charts to ensure orders are being entered correctly, medication doses are reasonable, and any conflicting allergies have been noted and accounted for.
Medication Therapy Management (MTM) is a term used to describe a broad range of services provided by pharmacists. These services can be provided in a pharmacy, but many times the services are provided over the telephone. This program was introduced when Medicare Part D (the prescription part of Medicare) was enacted in 2006. These services include medication therapy review, personal medication records, medication-related action plans, intervention and/or referrals, and documentation and follow-up. There are at least two organizations in the Alachua County area dedicated to MTM: Sinfonia, and the University of Florida programs. These services were included in Medicare Part D because it was recognized that pharmacists are an important part in preventing medication-related adverse events, which had reached an estimated 1.5 million preventable adverse events each year costing $177 billion.
I would like to conclude this series by telling about a unique pharmacy in our area. In 2017, Harvey Rohlwing M.D. and Tim Rogers RPh. were returning from a medical mission trip to Haiti. As they were talking on their way home, they wondered if they could find a way to provide medications to Alachua County’s poor and homeless population as was being done in Haiti. This was the seed of what is called Grace Pharmacy located at Grace Marketplace in Gainesville. All the patients it serves must be seen by the UF Mobile Clinic, Equal Access, or Helping Hands clinics. These clinics help with funding the medications; however, the pharmacy is staffed by pharmacists and technicians who volunteer their time. Alachua County has graciously given Grace Pharmacy a grant to have a part-time pharmacy coordinator. If you want more information visit https://www.gracehealthcs.com/. As mentioned above there is no charge for the prescription or the over-the-counter medications and the pharmacy does not have a cash register. Donations are welcome and can be given through the website.
Pharmacists are active in many areas of the healthcare system, from the most visible- community pharmacies- to a variety of institutional settings where they have limited visibility. Wherever they are, they are serving you and watching out for your interests and health.
What do you think?